It is difficult to get people to agree on the parameters of what we would define as "sexual health." Often it seems to go along the lines of whatever the person defining the concept is comfortable with themselves. This is even true in professional mental health circles where lots of dialogue and debate remain as to how we will classify the terms "dysfunction," "disorder" and in essence "deviant." In the process people often get labeled, diagnosed, treated, and mistreated in ways that carry more moral subjectivity than clinical soundness. I know this because I went 15 years as a well-trained mental health professional before I dove into the world of AASECT sex therapy certification where I had to face uncomfortable biases and values I realized I was imposing on my clients. Much responsibility comes in the voice of "expertise," especially in the already taboo and controversial world of sexuality.
It is positive, then, to see world health organizations and associations coming together in unified, evidence-based, community-positive ways to start paving the way for health centered foundations that deal in sexual health and sexual rights. One example is the World Association for Sexual Health and their Declaration of Sexual Rights. Another influencer has been Doug Braun- Harvey's work with Michael Vigorito that is found in Treating Out of Control Sexual Behavior: Rethinking Sex Addiction, where they coin the 6 Principles (or ingredients) of Sexual Health. Principles that all sexologists would largely be in agreement on.
They are as follow:
Are all partners in consensual agreement of the sexual interactions that are taking place in any given situation? And I would add the term "enthusiastic" agreement. This principle allows for consent to shift as an experience proceeds, with any partner being able to withdraw consent at any time during a sexual encounter. It also implies that wearing someone down until they consent is not what we are talking about. Any type of criminal behavior (including sexual acts between adults and supposed consenting minors) automatically disqualifies the concept of consent.
2. Non Exploitation
Are there power plays being used to coerce, guilt-trip, or manipulate sexual interactions? Whenever one person is using financial threats, bribes, "silent treatment/pouting," coercion, use of positional power, etc., they are using a form of exploitation to get something they want and prioritizing their needs over another person's. Exploitation usually leads to the disqualification of true consent.
3. Protection from Unwanted Pregnancy and Sexually Transmitted Infections
Are all partners involved in a sexual encounter committed to and using safe sex practices? From birth control methods for intercourse sex, to making sure bodily fluids are not causing risk through oral, vaginal and/or anal activity, to making sure to regular, recommended STI testing depending on your sexual activity risk.
Are all partners being honest about their history, expectations, commitment and behavior when it comes to sexual negotiation? Can partners be honest about their sexual tastes and preferences, fantasies, and desires? Is there secrecy within a sexual relationship that one of the partners would feel betrayed by? Is there room for elements of privacy in how we conceptualize honesty and do we talk about that openly?
5. Shared Values
Do the partners involved in a sexual encounter share similar values and agreements
about the type of sexuality they are engaging in? Do they intentionally and openly contract what falls between the parameters of what they agree to? If they differ in some of their values, what compromises have been made? Are the compromises compatible to all partners involved?
6. Mutual Pleasure
Is the pleasure of all partners involved in a sexual encounter prioritized? Is energy, time and communication spent making sure all partners know this is a priority? And can "pleasure" include conversations about orgasm but not be exclusive to orgasm?
These principles can be applied to married sex, non-married sex, monogamous sex, poly sex, casual sex, committed sex, heterosexual sex, queer sex, intercourse sex (penetrative), outercourse sex (non-penetrative), foreplay, young people sex, older people sex, and even sex within the realm of sex work. Often I see certain "types" of sex deemed as "bad" or "good." "Healthy" or "unhealthy." It is a much more expansive and accurate approach to apply these principles to any type of sex instead. Especially in the realm of sex education, don't lead teens to believe that "married" sex is better or safer than "casual" or "premarital" sex, without an explanation of these principles. I've seen plenty of cases of marital rape and exploitation. I've seen plenty of fun, stress relieving hookups. It's not the marriage or the hookup that is to "blame." It's whether or not the principles are present. Let's drink to that!
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Natasha Helfer Parker, LCMFT, CST
Natasha is the owner and founder of Symmetry Solutions. She is a Licensed Clinical Marriage & Family Therapist in the states of Kansas and Wisconsin and a Certified Sex Therapist. Natasha has been in practice for over 20 years and works with adults and adolescents. She specializes in mental health therapy, sex therapy and sexuality concerns, family/couples services and faith transitions within spiritual journeys.